Exelderm Solution — CareFirst (Caremark)
Tinea Cruris
Preferred products
- ciclopirox cream
- ciclopirox suspension/lotion (Loprox)
- clotrimazole cream
- clotrimazole solution
- econazole cream
- ketoconazole cream
- ketoconazole shampoo
- nystatin cream
- nystatin ointment
- nystatin powder
Initial criteria
- For all indications: The requested drug is NOT being used in a footbath.
- For Candidiasis/Candida: Authorization may be granted when the requested drug is ciclopirox cream or suspension/lotion (Loprox), clotrimazole cream or solution, econazole cream, ketoconazole cream, miconazole‑zinc oxide‑white petrolatum ointment (Vusion), or nystatin cream, ointment, or powder.
- For Seborrheic Dermatitis: Authorization may be granted when the requested drug is ciclopirox gel or shampoo (Loprox shampoo) or ketoconazole cream, foam, or shampoo.
- For Tinea Corporis: Authorization may be granted when the requested drug is ciclopirox cream, gel, suspension/lotion (Loprox), clotrimazole cream or solution, econazole cream, ketoconazole cream, luliconazole cream (Luzu), naftifine cream or 1% gel (Naftin 1% gel), oxiconazole cream or lotion (Oxistat), or sulconazole cream or solution (Exelderm).
- For Tinea Cruris: Authorization may be granted when the requested drug is ciclopirox cream or suspension/lotion (Loprox), clotrimazole cream or solution, econazole cream, ketoconazole cream, luliconazole cream (Luzu), naftifine cream or 1% gel (Naftin 1% gel), oxiconazole cream or lotion (Oxistat), or sulconazole cream or solution (Exelderm).
- For Tinea Pedis: Authorization may be granted when the requested drug is ciclopirox cream, gel, suspension/lotion (Loprox), clotrimazole cream or solution, econazole cream or foam (Ecoza), ketoconazole cream, luliconazole cream (Luzu), naftifine cream or gel (Naftin), oxiconazole cream or lotion (Oxistat), sertaconazole cream (Ertaczo), or sulconazole cream (Exelderm cream).
- For Tinea (Pityriasis) Versicolor: Authorization may be granted when the requested drug is butenafine cream (Mentax), ciclopirox cream or suspension/lotion (Loprox), clotrimazole cream or solution, econazole cream, ketoconazole cream or shampoo, oxiconazole cream (Oxistat cream), or sulconazole cream or solution (Exelderm).
Approval duration
3 months